scholarly journals Adenomatous Polyps in Adolescent Girl and Boy: A Report of Two Cases

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Laleh Vahedi Larijani ◽  
Maryam Ghasemi ◽  
Hassan Karami
Keyword(s):  
Pediatric Patients ◽  
Colonic Polyps ◽  
Definitive Diagnosis ◽  
Adenomatous Polyps ◽  
Common Symptom ◽  
Tubular Adenoma ◽  
Tubulovillous Adenoma ◽  
Benign Adenoma ◽  
Juvenile Type ◽  
Rectal Hemorrhage

A polyp is defined as a mass of the mucosal surface that protrudes into the lumen of the gastrointestinal tract. Neoplastic epithelial polyps are classified histologically as either benign adenoma or malignant carcinoma. The colonic polyps that most commonly present in children occur sporadically and individually and are of the juvenile type; they are most frequently associated with painless rectal hemorrhage (which is the most common symptom). Adenomatous polyps are similar to other nontumoral polyps, and it is very rare for children to have symptoms other than rectal bleeding. This report describes two rare cases of polyps in pediatric patients. An 11-year-old girl presented with tubulovillous adenoma and a 13-year-old boy with tubular adenoma; both patients complained of rectal hemorrhage as well as anemia and abdominal pain. Epithelial adenoma is a tumor that is rarely found in adults or children. Colonoscopic perforation and biopsy are mandatory for establishing a definitive diagnosis and avoiding medical mismanagement.

scholarly journals Types and Patterns of Colonic Polyps Encountered at a Tertiary Care Center in a Developing Country in South Asia

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Dakshitha Praneeth Wickramasinghe ◽  
Sanjeev F. Samaranayaka ◽  
Chamila Lakmal ◽  
Sashi Mathotaarachchi ◽  
Chula Kanishka Lal ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Colonic Polyps ◽  
Colorectal Polyps ◽  
Tubular Adenoma ◽  
Tubulovillous Adenoma ◽  
Chi Square ◽  
Chi Square Test ◽  
Pathology Reports ◽  
Spearman’S Correlation

Purpose. To identify the prevalence, types, and patterns of colonic polyps in a cohort of patients presenting to a tertiary care referral center in Sri Lanka.Methods. Endoscopy and pathology reports of a single unit from 2006 to 2013 were analyzed retrospectively. Spearman’s correlation coefficient and chi-square test were used to identify correlations.Results. There were a total of 158 patients (M : F, 10 : 57) who had polyps encountered on colonoscopy (n=1408) and flexible sigmoidoscopy (n=2402) with an incidence of 4.1%. Mean age was 56.5 years (SD 16.4) and the incidence of polyps increased with age. The majority (81.6%) had one polyp. A total of 188 polyps were assessed and most were seen in the rectum (33.5%) followed by sigmoid colon (22.9%). The commonest histological type was tubulovillous adenoma (33.5%) followed by tubular adenoma (24.5%). Most polyps were benign (91.5%). There was no statistically significant correlation with age or gender with malignancy, site, or histology.Discussion and Conclusion. The incidence of colorectal polyps was lower than the values reported in the west. More polyps were identified in males. There was no statistically significant association between age, gender, or multiplicity and malignant change in the polyps.

Concordancia entre el motivo de consulta y el diagnóstico final en pacientes pediátricos

2021 ◽  
Author(s):  
◽  
N. Castañeda-Villa
Keyword(s):  
Medical Records ◽  
Pediatric Patients ◽  
Interdisciplinary Team ◽  
Final Diagnosis ◽  
Definitive Diagnosis ◽  
Clinical Aspect ◽  
Observer Agreement ◽  
Medical Group ◽  
Research Assistant ◽  
Kappa Index

Concordance analysis using Cohen's Kappa index (􏰀􏰀) has been widely used in clinical research to determine the degree of agreement between two measurements made by the same observer (intra-observer agreement) or between the measurements of two observers on the same variable (inter- observer agreement). In this work, we used 􏰀􏰀 to determine the degree of inter-observer agreement between the reason for consultation and the final diagnosis issued by an interdisciplinary team of The Mexican Institute of Hearing and Language (IMAL). The institute receives around ten pediatric patients per month; the reasons for consulting these patients are diverse. In this research, 53 pediatric patients completed their studies in the IMAL and received a final diagnostic. A research assistant manually collected the data from the medical records of the IMAL Medical Direction. For example, 1) reason for consultation, 2) studies carried out, 3) recommendations, and 4) the final diagnosis. The global concordance between consultation and the definitive diagnosis was 􏰀􏰀 = 0.44 (moderate concordance). Although a Health Professional suggested the reason for consultation, it only covers a clinical aspect. Therefore, we think that the moderate concordance obtained is since an interdisciplinary medical group issues the final diagnostic, achieving a complete diagnosis; this allows the adequate medical care and rehabilitation of the pediatric patient.

scholarly journals A Mini Review on Current Clinical and Research Findings for Children Suffering from COVID-19

2020 ◽  
Author(s):  
Xiao Li ◽  
Kun Qian ◽  
Ling-ling Xie ◽  
Xiu-juan Li ◽  
Min Cheng ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Secondary Infection ◽  
Age Groups ◽  
Research Direction ◽  
Cochrane Library ◽  
Common Symptom ◽  
Ct Examination ◽  
Short Period ◽  
Novel Coronavirus ◽  
Global Threat

AbstractBackgroundAs the novel coronavirus triggering COVID-19 has broken out in Wuhan, China and spread rapidly worldwide, it threatens the lives of thousands of people and poses a global threat on the economies of the entire world. However, infection with COVID-19 is currently rare in children.ObjectiveTo discuss the latest findings and research focus on the basis of characteristics of children confirmed with COVID-19, and provide an insight into the future treatment and research direction.MethodsWe searched the terms “COVID-19 OR coronavirus OR SARS-CoV-2” AND “Pediatric OR children” on PubMed, Embase, Cochrane library, NIH, CDC, and CNKI. The authors also reviewed the guidelines published on Chinese CDC and Chinese NHC.ResultsWe included 25 published literature references related to the epidemiology, clinical manifestation, accessary examination, treatment, and prognosis of pediatric patients with COVID-19.ConclusionThe numbers of children with COVID-19 pneumonia infection are small, and most of them come from family aggregation. Symptoms are mainly mild or even asymptomatic, which allow children to be a risk factor for transmission. Thus, strict epidemiological history screening is needed for early diagnosis and segregation. This holds especially for infants, who are more susceptible to infection than other age groups in pediatric age, but have most likely subtle and unspecific symptoms. They need to be paid more attention to. CT examination is a necessity for screening the suspected cases, because most of the pediatric patients are mild cases, and plain chest X-ray do not usually show the lesions or the detailed features. Therefore, early chest CT examination combined with pathogenic detection is a recommended clinical diagnosis scheme in children. The risk factors which may suggest severe or critical progress for children are: Fast respiratory rate and/or; lethargy and drowsiness mental state and/or; lactate progressively increasing and/or; imaging showed bilateral or multi lobed infiltration, pleural effusion or rapidly expending of lesions in a short period of time and/or; less than 3 months old or those who underly diseases. For those critical pediatric patients with positive SARS-CoV-2 diagnosis, polypnea may be the most common symptom. For treatment, the elevated PCT seen in children in contrast to adults suggests that the underlying coinfection/secondary infection may be more common in pediatric patients and appropriate antibacterial treatment should be considered. Once cytokine storm is found in these patients, anti-autoimmune or blood-purifying therapy should be given in time. Furthermore, effective isolation measures and appropriate psychological comfort need to be provided timely.

scholarly journals Features of the course and comparative characteristics of gastroesophageal reflux disease in pediatric patients with esophageal atresia after primary repair

2020 ◽  
pp. 24-29
Author(s):  
M.G. Aksionchyk ◽  
◽  
K.Y. Marakhousk ◽  
V.I. Averin ◽  
◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Esophageal Atresia ◽  
Reflux Disease ◽  
Pediatric Patients ◽  
Impedance Measurement ◽  
Index Number ◽  
Common Symptom ◽  
Esophageal Mucosa ◽  
Significant Difference

The aim is to evaluate clinical data and data of intraesophageal 24-hour pH/impedance measurement in pediatric patients with corrected esophageal atresia. Material and methods. A retrospective analysis was carried out on the basis of inpatient records of 43 pediatric patients with corrected esophageal atresia (CEA) aged from 1 to 14 years, who were examined at the State Institution «Republican Scientific and Practical Center of Pediatric Surgery» from November 2017 to March 2020. Average age of the group: 5.09±1.2 years, of which 23 boys (53.5%), 20 girls (46.5%). All patients with CEA underwent esophagogastroduodenoscopy (EGD) and intraesophageal 24-hour pH/impedance measurement while off acid-suppressive therapy. Results. Depending on the results of pH/impedance measurement, the patients with CEA were divided into two groups: CEA with gastroesophageal reflux disease (GERD) – 20 (54.1%) and CEA without GERD – 17 (45.9%). The most common symptom in patients with CEA was cough in both groups, in 26 (70.27%) children. Only in 4 out of 37 patients with CEA no symptoms during the time of the study were registered. Upper gastrointestinal tract endoscopy showed that 16 (43.2%) children with CEA had grade A esophagitis (according to the Los Angeles classification), 1 (2.7%) had gastric metaplasia of the esophageal mucosa, and 6 (16.2%) had chronic gastritis. EGD data did not reveal any significant differences between CEA patients with GERD and CEA patients without GERD (P=0.819). When comparing pH/impedance parameters, a significant difference (P<0.005) was obtained for the following parameters: reflux index, number of reflux episodes, distal mean nocturnal baseline impedance (MNBI) and duration of the longest reflux episode. In addition, the positive association of symptoms with episodes of refluxes (>95%) in the group of CEA patients without GERD was significantly higher than in CEA patients with GERD: 3/20 (15%) versus 8/17 (47.06%). Conclusions. The prevalence of GERD in patients with CEA in this study was 54.06%. Extraesophageal symptoms (in particular, cough) are prevalent in patients with CEA (70.3%). GERD can be asymptomatic in patients with CEA. In this study, 15% of CEA patients with confirmed GERD were asymptomatic. Patients with CEA in the study groups rarely had typical GERD symptoms (heartburn, regurgitation, chest pain and belching). The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institutions indicated in the article. Informed consent of parents and children was obtained for the research. The authors declare no conflicts of interest. Key words: corrected esophageal atresia, gastroesophageal reflux disease, esophagitis, children, esophageal 24-hour pH/impedance measurement.

scholarly journals Seizure outcome in moyamoya after indirect revascularization in pediatric patients: Retrospective study and literature review

2021 ◽  
Vol 12 ◽  
pp. 73
Author(s):  
Abdullah Alramadan ◽  
Anwar Ul Haq ◽  
Sarah Basindwah ◽  
Essam Alshail
Keyword(s):  
Pediatric Patients ◽  
Treatment Options ◽  
Seizure Outcome ◽  
Common Symptom ◽  
Cerebrovascular Disorder ◽  
Surgical Revascularization ◽  
Uncommon Disease ◽  
Bilateral Surgery ◽  
Indirect Revascularization ◽  
Primary Presentation

Background: Moyamoya disease (MMD) is a unique cerebrovascular disorder characterized by progressive stenosis of anterior cerebral circulation. Moyamoya is not an uncommon disease in Saudi Arabia. Although a less common symptom of the disease, the incidence of seizure in MMD ranges from 6 to 30%. Indirect revascularization through Encephaloduroarteriosynangiosis technique is one of the surgical treatment options for MMD. In our cohort, we aim to evaluate seizure outcome in pediatric patients with moyamoya. Methods: Eleven patients with seizure as primary presentation for MMD over a period of 10 years were included in the study. All patients underwent EDAS surgery. All patients underwent pre- and postoperative assessment of multiple factors contributing to seizure outcome. Patients were evaluated for surgery control clinically and radiologically. Results: About 73% of MMD patients with seizures improved after EDAS surgery (P < 0.0005). Six patients out of 11 became seizure free. Patients with bilateral involvement of disease undergoing bilateral surgery had better seizure control than those undergoing unilateral surgery (P < 0.07). Conclusion: Patients with controlled seizure before surgery are more likely to be seizure free after intervention. Seizure outcome is favorable after indirect surgical revascularization in pediatric moyamoya patients.

BİR EĞİTİM ARAŞTIRMA HASTANESİNDE ALT GASTROİNTESTİNAL SİSTEM BULGULARININ DEĞERLENDİRİLMESİ

2021 ◽  
Vol 8 (16) ◽  
pp. 16-20
Author(s):  
Nursel ÜSTÜNDAĞ ÖCAL ◽  
Sevda YAMAN ◽  
Serdar YANIK
Keyword(s):  
Hyperplastic Polyp ◽  
Occult Blood ◽  
Outpatient Clinics ◽  
Central Anatolia ◽  
Bowel Habit ◽  
Tubular Adenoma ◽  
Hyperplastic Polyps ◽  
Tubulovillous Adenoma ◽  
Important Place ◽  
The Mean

Patients with complaints about colorectal region refer to general surgery, gastroenterology and other outpatient clinics with an increasing frequency. Rectal bleeding, abdominal pain, unexplained anemia, changes in bowel habit, occult blood positivity in stool can be a sign of serious colon disease. In this study, patients under the age of 65 who underwent AGIS endoscopy in the endoscopy unit of the Research and Application Hospital in Central Anatolia Region between 2015 and 2018 were examined. The data were reviewed retrospectively. 214 patients under the age of 65 were included in the study. Colitis in 37 (17.29%), hyperplastic polyp in 38 (17.76%), tubular adenoma in 86 (40.19%), tubular adenoma in 40 (18.69%), Adenocarcinoma was detected in 13 (6.7%) of results. Tubular adenoma, tubulovillose adenoma and adenocarcinomas were more common at the age of fifties, with colitis and hyperplastic polyps detected in the mean age of forties. Adenocarcinomas were found to be more common in female sex, unlike other results. Lower gis endoscopy has an important place in the diagnosis and treatment of colorectal cancer. In our study, in which the results of AGIS endoscopy were examined, tubular adenoma was high in individuals under 65 years of age. Keywords: Tubulovillous Adenoma, Colitis, Hyperplastic Polyp

scholarly journals Outcome of endoscopic resection of colonic polyps larger than 10 mm in patients with inflammatory bowel disease

2019 ◽  
Vol 07 (08) ◽  
pp. E994-E1001 ◽  
Author(s):  
Siddhant Yadav ◽  
Edward V. Loftus ◽  
W. Scott Harmsen ◽  
Louis M. Wong Kee Song ◽  
Nayantara Coelho-Prabhu
Keyword(s):  
Inflammatory Bowel Disease ◽  
Endoscopic Resection ◽  
Bowel Disease ◽  
Colonic Polyps ◽  
Published Data ◽  
Low Grade ◽  
Tubular Adenoma ◽  
En Bloc ◽  
Maximal Diameter ◽  
Inflammatory Bowel

Abstract Background and study aims There are limited published data on endoscopic removal of colorectal polyps by endoscopic mucosal resection (EMR) and endoscopic mucosal dissection (ESD) in patients with inflammatory bowel disease (IBD). Patients and methods We performed a retrospective review of patients with colonic IBD and colonic polyps >10mm who underwent EMR and/or ESD at our institution between January 1, 2012 and June 31, 2016. Results Ninety-seven patients with pathology-confirmed IBD (median disease duration 16 years) were included. Mild or moderate active colitis (in background biopsies) was seen in 85 %. Of the total 124 polyps, location was ascending colon in 44 %, transverse in 15 % and sigmoid in 18.5 %; of the total, 55 % were < 20 mm and 45 % were ≥20mm in maximal diameter. Using the Paris classification, 56 % of polyps were polypoid sessile (Is) polyps, while 38 % were non-polypoid (IIa, IIb, IIc). EMR was used in 118 polyps, three required ESD, and three by combined EMR-ESD. Seventy-two percent were resected en-bloc; 28 % underwent piecemeal resection. Histology included low-grade dysplasia in 75, serrated adenoma in 31, and tubular adenoma in 14 polyps. Chromoendoscopy was used in 33 (26.6 %). Adverse events occurred in three patients. Colectomy was performed in 11 patients within 12 months. Recurrence was seen in 20 polyps, 11 of which were successfully resected en-bloc using EMR. Polyps ≥ 20 mm and polyps treated with APC were found to have a statistically significantly higher risk of recurrence. Conclusion This study demonstrates the efficacy and safety of endoscopic resection of large polyps in patients with IBD, making them effective alternatives to colectomy.

scholarly journals Rathke cleft cysts in pediatric patients: presentation, surgical management, and postoperative outcomes

2011 ◽  
Vol 31 (1) ◽  
pp. E3 ◽  
Author(s):  
Arman Jahangiri ◽  
Annette M. Molinaro ◽  
Phiroz E. Tarapore ◽  
Lewis Blevins ◽  
Kurtis I. Auguste ◽  
...  
Keyword(s):  
San Francisco ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Growth Delay ◽  
Common Symptom ◽  
Imaging Findings ◽  
Presenting Symptoms ◽  
Sellar Lesions ◽  
Kaplan Meier ◽  
Study Results

Object Rathke cleft cysts (RCC) are benign sellar lesions most often found in adults, and more infrequently in children. They are generally asymptomatic but sometimes require surgical treatment through a transsphenoidal corridor. The purpose of this study was to compare adult versus pediatric cases of RCC. Methods The authors retrospectively reviewed presenting symptoms, MR imaging findings, laboratory study results, and pathological findings in 147 adult and 14 pediatric patients who underwent surgery for treatment of RCCs at the University of Californial at San Francisco between 1996 and 2008. Results In both the adult and pediatric groups, most patients were female (78% of adults, 79% of pediatric patients, p = 0.9). Headache was the most common symptom in both groups (reported by 50% of pediatric patients and 33% of adults, p = 0.2). Preoperative hypopituitarism occurred in 41% of adults and 45% of pediatric patients (p = 0.8). Growth delay, a uniquely pediatric finding, was a presenting sign in 29% of pediatric patients. Visual complaints were a presenting symptom in 16% of adult and 7% of pediatric patients (p = 0.4). There was no difference between median cyst size in adults versus pediatric patients (1.2 cm in both, p = 0.7). Temporary or permanent postoperative diabetes insipidus occurred in 12% of adults and 21% of pediatric patients (p = 0.4). Kaplan-Meier analysis revealed an 8% RCC recurrence rate at 2 years for each group (p = 0.5). Conclusions The incidence of RCCs is much lower in the pediatric population; however, symptoms, imaging findings, and outcomes are similar, suggesting that pediatric RCCs arise from growth of remnants of the embryonic Rathke pouch earlier in life than adult RCCs but do not differ in any other way. It is important to consider RCCs in the differential diagnosis when pediatric patients present with visual impairment, unexplained headache, or hypopituitarism including growth delay. Although the average RCC size was similar in our pediatric and adult patient groups, the smaller size of the pituitary gland in pediatric patients suggests an increased relative RCC size.

scholarly journals Clinical and Epidemiological Characteristics of 1283 Pediatric Patients with Coronavirus Disease 2019 during the First and Second Waves of the Pandemic—Results of the Pediatric Part of a Multicenter Polish Register SARSTer

2021 ◽  
Vol 10 (21) ◽  
pp. 5098
Author(s):  
Maria Pokorska-Śpiewak ◽  
Ewa Talarek ◽  
Anna Mania ◽  
Małgorzata Pawłowska ◽  
Jolanta Popielska ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Clinical Presentation ◽  
Gastrointestinal Symptoms ◽  
Common Symptom ◽  
Multicenter Cohort Study ◽  
Age Related ◽  
Asymptomatic Patients ◽  
Close Relatives ◽  
Epidemiological Characteristics ◽  
Second Wave

This prospective multicenter cohort study aimed to analyze the epidemiological and clinical characteristics of coronavirus disease 2019 (COVID-19) in children. The study, based on the pediatric part of the Polish SARSTer register, included 1283 children (0 to 18 years) who were diagnosed with COVID-19 between 1 March 2020 and 31 December 2020. Household contact was reported in 56% of cases, more frequently in younger children. Fever was the most common symptom (46%). The youngest children (0–5 years) more frequently presented with fever, rhinitis and diarrhea. Teenagers more often complained of headache, sore throat, anosmia/ageusia and weakness. One fifth of patients were reported to be asymptomatic. Pneumonia was diagnosed in 12% of patients, more frequently in younger children. During the second wave patients were younger than during the first wave (median age 53 vs. 102 months, p < 0.0001) and required longer hospitalization (p < 0.0001). Significantly fewer asymptomatic patients were noted and pneumonia as well as gastrointestinal symptoms were more common. The epidemiological characteristics of pediatric patients and the clinical presentation of COVID-19 are age-related. Younger children were more frequently infected by close relatives, more often suffered from pneumonia and gastrointestinal symptoms and required hospitalization. Clinical courses differed significantly during the first two waves of the pandemic.

scholarly journals Squamous Metaplasia in Colonic Tubulovillous Adenoma: A Three Case Series and review of literature

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S66-S66
Author(s):  
D Duhoki ◽  
D Allison ◽  
E Wiley
Keyword(s):  
Squamous Metaplasia ◽  
Case Series ◽  
Colonic Polyps ◽  
Colorectal Polyps ◽  
High Grade Dysplasia ◽  
High Grade ◽  
Tubulovillous Adenoma ◽  
Polyp Size ◽  
Eosinophilic Cytoplasm

Abstract Introduction/Objective Although squamous metaplasia of colonic tubulovillous adenoma is a rare phenomenon, colorectal polyps can show focal squamous metaplasia. While the exact cause in unknown, it has been suggested that mechanical irritation, torsion and chronic inflammation may predispose to squamous metaplasia within large colonic polyps. Methods/Case Report We observed this finding in two men and one woman with colorectal polyps who underwent endoscopic mucosal resection in a three-week timeframe. In two cases the polyps were rectal, while in the third case, it was located in the descending colon. Polyp size ranged from 1-5 cm and were semi-pedunculated. Histologically, all three lesions were tubulovillous adenomas with focal high-grade dysplasia and multiple foci of squamous metaplasia characterized by cells with benign-appearing nuclei, eosinophilic cytoplasm, and solid growth pattern. Some metaplastic foci approached the muscularis mucosae, mimicking adenocarcinoma at low power magnification. Interestingly, these metaplastic foci were reactive against p16 immunohistochemical stain. Results (if a Case Study enter NA) NA Conclusion We present these three cases to add to the few previously reported. Pathologists should be aware of this finding to avoid the overdiagnosis of invasive carcinoma in the setting of nested and pseudo invasive squamous morules, especially in polyps with high grade dysplasia. In addition, squamous metaplasia could be a precursor lesion for colorectal squamous cell carcinoma.

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